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Organization
SERENITY HAVEN ADULT DAY CARE INC
Active
Organization
SERENITY HAVEN ADULT DAY CARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NIKKITA C JOHNSON- NEEALY (OWNER/NURSE)
(708) 476-3795
Entity
Organization
Contact information
Practice address
1109 E 156TH ST, DOLTON, IL 60419-2777
(708) 476-3795
(773) 821-0720
Mailing address
1458 W 123RD ST, CHICAGO, IL 60643-5768
(773) 454-8514
(773) 821-0720
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043.087417
IL
Other
Enumeration date
03/26/2009
Last updated
05/01/2009
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